CN105852931A - Additive-manufactured guiding positioning assembly for jawbone tumor resection and reconstruction - Google Patents
Additive-manufactured guiding positioning assembly for jawbone tumor resection and reconstruction Download PDFInfo
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- CN105852931A CN105852931A CN201610288256.6A CN201610288256A CN105852931A CN 105852931 A CN105852931 A CN 105852931A CN 201610288256 A CN201610288256 A CN 201610288256A CN 105852931 A CN105852931 A CN 105852931A
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- jawbone
- guiding
- osteotomy
- plate
- localizer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/176—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
- A61C8/009—Implanting tools or instruments for selecting the right implanting element, e.g. templates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
Abstract
The invention provides an additive-manufactured guiding positioning assembly for jawbone tumor resection and reconstruction. The additive-manufactured guiding positioning assembly sequentially comprises a first guiding positioner, a second guiding positioner and a third guiding positioner according to the jawbone tumor resection and reconstruction operation process; the first guiding positioner is fixed to the fibula and assists in fibular osteotomy shaping; the second guiding positioner is fixed to the sclerotin parts of the front side and the back side of a jawbone tumor and assists in jawbone tumor resection; the third guiding positioner is connected with the osteotomy part of the fibula and connected between the sclerotin parts of the front side and the back side of the position where the jawbone tumor is resected and assists in jawbone reconstruction by taking the osteotomy part of the fibula as grafted bone. By means of the additive-manufactured guiding positioning assembly, operations such as fibular osteotomy, jawbone tumor resection and jawbone reconstruction can be guided to be accurately implemented, operation is easy and convenient, the experience requirements for an operator are low, and the problem of surgical operation errors caused due to the fact that the operator operates by feel can be completely eradicated.
Description
Technical field
The present invention relates to medical instruments field, particularly relate to increase excising for Jaw neoplasm and rebuilding of material manufacture
Guiding positioning component.
Background technology
Tumor invading, inflammation, wound and radiotherapy are the main causes causing jawbone to destroy, operative treatment
Usually need to excise bulk jawbone, necessarily cause patient facial region's external defects and the forfeiture of occlusion masticatory function,
This is accomplished by superior reconstruction technology, intercepts the nonweight-bearing one section of fibula of autologous shank, fashions into jawbone
Shape similarity metric jawbone be most currently used means.But, Jaw neoplasm excision the most both at home and abroad and weight
Build and operation generally there are following defect:
(1) it is shaped as straight type due to shank fibula, and jawbone is the multi-C stereo mixture of L-type, arch,
So needing doctor repeatedly to be blocked by fibula in Shou Shu and bending the form fashioning into approximation jawbone, difficulty can be thought
And know, wasting time and energy in art, operator skill requirement is high, and it is undesirable that this also often results in reconstruction effect
Main cause.
(2) Jaw neoplasm resection operation half-blindness depending under carry out, working place is little, technology require height, operation
Difficulty is big, causes owing to lacking experience resection error excessive, causes fibula to mate with jaw defect position
Bad, and easily residual disease tissue, there is the risk of postoperative recurrence.
(3) colleague is primarily focused in the form of reconstruction of jaw more the most both at home and abroad, i.e. the outward appearance of patient
Recovery aspect, but ignores the recovery of the occlusion masticatory function of patient, and occlusion masticatory function is bad to trouble in fact
The Quality of Life of person is bigger.A large amount of reconstruction of jaw cases that we complete in early days, have recovered patient smoothly
Outward appearance, the difficulty but the most of patients later stage has a denture made, have impact on the recovery of occlusion masticatory function.The calf transplanted
Carrying out the reparation of removable denture on bone, often maintenance is poor, and masticatory efficiency is low, and Dental Implant maintenance is good,
It is the ideal style recovering meshing functions, is conducive to having a denture made, the most beneficially the reconstruction of jaw of Dental Implant
Scheme is pursuing a goal of Oral and Maxillofacial Surgery and Prosthodontics doctor, but often because reconstruction of jaw position
Deficient accuracy and deficient reasonability, implantation body's implant angle or the degree of depth not good enough, cause Most patients to lose
Dental Implant chance.
Summary of the invention
The technical problem to be solved is, it is provided that a kind of increase material manufacture for Jaw neoplasm excise
With the guiding positioning component rebuild, it is possible to guide the operations such as the excision of fibula osteotomy, Jaw neoplasm and reconstruction of jaw
Can implement exactly, easy and simple to handle, low to the skill requirement of operator, operator can be stopped with sensation behaviour
The operation technique error problem made and cause.
In order to solve above-mentioned technical problem, the invention provides and increase excising for Jaw neoplasm and weight of material manufacture
The guiding positioning component built, includes the first guiding location successively according to Jaw neoplasm excision and reconstruction operations process
Device, the second guiding localizer and the 3rd guide localizer, and described first guides localizer to be fixed on fibula,
And assist fibula osteotomy moulding；Described second guides localizer to be fixed on the sclerotin portion of both sides before and after Jaw neoplasm
Position, and assist Jaw neoplasm to excise；Described 3rd guides localizer to be connected with the osteotomy part of fibula, described
3rd guide localizer to be connected to excise after Jaw neoplasm before and after both sides sclerotin position between, and with fibula
Osteotomy part assist reconstruction of jaw as bone graft；Described first guides localizer, the second guiding localizer
Localizer is guided all to use resin or plastics by 3D printing shaping with the 3rd.
As preferred scheme, described first guides localizer to include the first osteotomy guide plate and location latch closure, institute
State the first osteotomy guide plate and be provided with the long trough curve-surface cavity of the osteotomy part surface of bone laminating with fibula, described location
Latch closure is provided with two, be buckled in respectively position that the osteotomy part two ends with fibula are connected and with described first section
The two ends of bone conduction plate connect, and described location latch closure is provided with the position fastening that the osteotomy part two ends with fibula are connected
Annular surface die cavity, the long trough of the annular surface die cavity of described location latch closure and described first osteotomy guide plate
Curve-surface cavity abrupt transition, described first osteotomy guide plate is provided with multiple for guiding operator to open on fibula
If screwed hole and be available for the first guiding installing hole that the first osteotomy guide plate is connected with fibula.
As preferred scheme, the end of described location latch closure is extended with tenon, described first osteotomy guide plate
It is respectively arranged at two ends with the tongue-and-groove being connected with described tenon.
As preferred scheme, being respectively arranged at two ends with from described first osteotomy guide plate of described first osteotomy guide plate
The outwardly directed first section leads limit of end face；Described first osteotomy guide plate is provided with bending and guides fracture,
It is V-shaped that described bending guides fracture.
As preferred scheme, described second guides localizer to include that two pieces are arranged at both sides before and after Jaw neoplasm
The second osteotomy guide plate at sclerotin position, described second osteotomy guide plate be provided with jawbone outside in surface of bone laminating
Side, described second osteotomy guide plate is provided with for guiding operator offer screwed hole on jawbone and be available for
The second guiding installing hole that described second osteotomy guide plate is connected with jawbone.
As preferred scheme, the described second osteotomy guide plate end face near Jaw neoplasm side is provided with from this end
Face out the second section leads limit stretched out；The lateral surface of described second osteotomy guide plate is provided with boss, described
Guide installing hole and be opened in described boss central authorities；Described second osteotomy guide plate extends what oriented jawbone edge held
Buckling parts.
As preferred scheme, the described 3rd guides localizer to include bone graft guided plate, Dental implantion bullport
Seat, anterior jawbone fixed plate and rear portion jawbone fixed plate, the guide tracks of described bone graft guided plate and jawbone
The extension track rebuild coordinates consistent, and described bone graft guided plate offers some bone graft fixing holes, institute
Stating bone graft fixing hole corresponding with the screwed hole on fibula, described Dental implantion bullport seat is arranged at described shifting
On bone grafting guided plate and its aperture is relative with bone graft, described anterior jawbone fixed plate and rear portion jawbone fixed plate
It is connected to the two ends of described bone graft guided plate and is provided with and the medial surface of corresponding jawbone surface of bone laminating,
Being equipped with some jawbone fixing holes in described anterior jawbone fixed plate and rear portion jawbone fixed plate, described jawbone is solid
Determine hole corresponding with the screwed hole on jawbone.
As preferred scheme, described bone graft guided plate extends on the upside of oriented bone graft or downside holds the
One buckling parts, described Dental implantion bullport seat is arranged on described first buckling parts；Described anterior jawbone is fixed
The side of plate extends the second buckling parts that oriented jawbone edge holds, the opposite side of described anterior jawbone fixed plate
It is provided with the 3rd buckling parts fastened with tooth or teeth space；Described rear portion jawbone fixed plate extends oriented jawbone edge
The 4th buckling parts held.
As preferred scheme, the central axis in the hole of described Dental implantion bullport seat in bone graft surface of bone,
Coordinate to be plugged with on described Dental implantion bullport seat and be available for the guide pillar that different-diameter drill bit passes, described guide pillar bag
Including cylinder-shaped body, described cylinder-shaped body is provided with the shoulder hole that the hole with described Dental implantion bullport seat communicates,
The top of described shoulder hole is major diameter, and bottom is minor diameter；The periphery of described cylinder-shaped body is provided with projection
Portion, the lower surface of described lobe coordinates with the upper surface of described Dental implantion bullport seat.
As preferred scheme, described bone graft guided plate is provided with the titanium plate location extended along bone graft track
Groove, described titanium plate locating slot offers and some are available for whole screw and are connected to one through by titanium plate and bone graft
The through hole risen.
That implements the present invention increases the guiding positioning component excising for Jaw neoplasm and rebuilding that material manufactures, with existing
There is technology to compare, have the advantages that
(1) the first guiding localizer auxiliary according to Jaw neoplasm excision and reconstruction operations process, first, is utilized
Fibula osteotomy is moulding；Secondly, the second guiding localizer auxiliary Jaw neoplasm excision is utilized；Finally, is utilized
Three guide localizer auxiliary reconstruction of jaw；Visible, in whole operation process, by guiding localizer accordingly,
The operations such as the excision of fibula osteotomy, Jaw neoplasm and reconstruction of jaw are guided to implement exactly, easy and simple to handle,
Low to the skill requirement of operator, the operation technique error problem that operator causes can be stopped with sensation operation；
Further, 3 guiding localizers all use resin or plastics by 3D printing shaping, it can be ensured that complete complexity
Accurate per-sonalization structures makes.
(2) the first guiding localizer of the present invention is by positioning the design of latch closure, makes the first osteotomy guide plate and calf
Bone is in place accurately, prevents the first osteotomy guide plate from twisting on fibula or sliding, it is ensured that fibula is set as predetermined
Meter scheme osteotomy is moulding, and surgical effect is accurate；Meanwhile, also by the first setting guiding installing hole, for rear
Titanium plate, bone graft and the 3rd in continuous reconstruction of jaw operation guides the spiral shell that the connection offer between localizer is unified
Pit, it is to avoid titanium plate, bone graft and the 3rd guide localizer to fix the bone graft damage that secondary drilling causes,
Also ensure that the accuracy that titanium plate, bone graft and the 3rd guiding localizer are in place at jaw defect.
(3) the second guiding localizer of the present invention is by the setting of the second guiding installing hole, can make second section
Bone conduction plate is held in a predetermined position and firm stable, it is to avoid sliding occurs during excision Jaw neoplasm, makes jawbone
Tumor resection is easier to make for, it is simple to patient operates；Through second osteotomy guide plate guide under accurate along border
Excision Jawbone Pathoses region safely, it is to avoid residual, effectively reduces the risk of postoperative recurrence, is follow-up simultaneously
Titanium plate and the 3rd in reconstruction of jaw operation guides the screwed hole that the connection offer between localizer is unified, it is to avoid
Titanium plate and the 3rd guides localizer to fix the jawbone damage that secondary drilling causes, and also ensures that titanium plate and the 3rd draws
Lead the accuracy that localizer is in place at jaw defect.
(4) the 3rd guiding localizer of the present invention uses and collects Dental implantion and reconstruction of jaw in integral structure, logical
Cross design Dental implantion bullport seat on bone graft guided plate, it is possible to make bone graft guided plate guide jawbone weight
While building operation, assist Dental implantion part operation, as implantation hole preparation, implantation body implant, be greatly improved
Operation precision and success rate.
Accompanying drawing explanation
In order to be illustrated more clearly that the technical scheme of the embodiment of the present invention, the accompanying drawing of embodiment will be made letter below
Singly introduce.
Fig. 1 is the decomposition chart of the first guiding localizer；
Fig. 2 is first guiding localizer structural representation when being connected with fibula；
Fig. 3 is second guiding localizer structural representation when being connected with mandibular bone；
Fig. 4 is the 3rd to guide localizer outer side view when being connected with mandibular bone；
Fig. 5 is the 3rd inner side view guiding localizer；
Fig. 6 is the sectional view of guide pillar.
Detailed description of the invention
Below in conjunction with the accompanying drawing in the embodiment of the present invention, the technical scheme in the embodiment of the present invention is carried out clearly
Chu, be fully described by, it is clear that described embodiment be only a part of embodiment of the present invention rather than
Whole embodiments.Based on the embodiment in the present invention, those of ordinary skill in the art are not making creation
The every other embodiment obtained under property work premise, broadly falls into the scope of protection of the invention.
In conjunction with seeing Fig. 1 to Fig. 6, the preferred embodiments of the present invention, a kind of increase material manufacture for Jaw neoplasm
Excision and the guiding positioning component rebuild, include first successively according to Jaw neoplasm excision and reconstruction operations process
Guiding localizer 1, second to guide localizer 2 and the 3rd to guide localizer 3, described first guides localizer
1 is fixed on fibula 4, and assists fibula osteotomy moulding；Described second guides localizer 2 to be fixed on jawbone swells
The sclerotin position (i.e. anterior jawbone and rear portion jawbone) of both sides before and after tumor 51, and assist Jaw neoplasm to excise；
Described 3rd guides localizer 3 to be connected with the osteotomy part of fibula 4, and the described 3rd guides localizer 3 to connect
Before and after after excision Jaw neoplasm between the sclerotin position (i.e. anterior jawbone and rear portion jawbone) of both sides, and
Reconstruction of jaw is assisted as bone graft 41 using the osteotomy part of fibula 4.Visible, Jaw neoplasm excision and reconstruction
Operation process is: first, utilizes the first guiding localizer 1 to assist fibula osteotomy moulding；Secondly, the is utilized
Two guide localizer 2 to assist Jaw neoplasm to excise；Finally, the 3rd guiding localizer 3 is utilized to assist jawbone weight
Build.In whole operation process, by guiding localizer accordingly, guide the excision of fibula osteotomy, Jaw neoplasm
Operate can implement exactly with reconstruction of jaw etc., easy and simple to handle, low to the skill requirement of operator, can shut out
The operation technique error problem that operator causes with sensation operation absolutely.It should be noted that described first draws
Leading localizer 1, second guides localizer 2 and the 3rd to guide localizer 3 all to use resin or plastics to pass through 3D
Printing shaping, it can be ensured that complete complicated accurate per-sonalization structures and make.
As depicted in figs. 1 and 2, the form that specifically arranges of described first guiding localizer 1 is as follows:
Described first guides localizer 1 to include the first osteotomy guide plate 11 and location latch closure 12, described first osteotomy
Guide plate 11 is provided with the long trough curve-surface cavity of the osteotomy part surface of bone laminating with fibula 4, described location latch closure 12
Be provided with two, be buckled in respectively position that the osteotomy part two ends with fibula 4 are connected and with described first osteotomy
The two ends of guide plate 11 connect, and described location latch closure 12 is provided with the portion that the osteotomy part two ends with fibula 4 are connected
The annular surface die cavity that position fastens, the annular surface die cavity of described location latch closure 12 and described first osteotomy guide plate
The long trough curve-surface cavity abrupt transition of 11, described first osteotomy guide plate 11 is provided with multiple for guiding operation
Person offers screwed hole on fibula 4 and is available for the first guiding that the first osteotomy guide plate 11 is connected with fibula 4
Installing hole 13.
In the present embodiment, obtain the head mathematical model of patient by CBCT or CT scan, by software three
Dimension reconstruction technique sets up Three-dimensional model.Computer software is used to formulate hands on 3-dimensional digital skull model
Art scheme also draws fibula osteotomy boundary line and screwed hole, according to the scope of osteotomy boundary line and screwed hole
Position draws the first osteotomy guide plate 11 and the profile of location latch closure 12, and uses the nontoxic material such as resin, plastics
Expect to be become the first osteotomy guide plate 11 and the location latch closure 12 of entity by 3D printing shaping fabrication techniques.Described
The long trough curve-surface cavity of one osteotomy guide plate 11 is according to the outside surface of bone form in the range of fibula osteotomy boundary line
Generate, with the outside surface of bone laminating of the osteotomy part of fibula 4；Described location latch closure 12 is provided with two, its ring
Shape curve-surface cavity is according to the outside surface of bone form generating outside the scope of fibula osteotomy boundary line, with fibula 4
The position that osteotomy part two ends are connected fastens, and the end of described location latch closure 12 is extended with tenon 14, and described the
One osteotomy guide plate 11 be respectively arranged at two ends with the tongue-and-groove 15 being connected with described tenon 14, from there through tenon
14 and the cooperation of tongue-and-groove 15, make linking together of location latch closure 12 and the first osteotomy guide plate 11, from
And effectively preventing the first osteotomy guide plate 11 from twisting on fibula or sliding, it is ensured that fibula presses predetermined design side
Case osteotomy is moulding, and surgical effect is accurate.Described first osteotomy guide plate 11 is provided with multiple first and guides installing hole
13, according to the first position guiding installing hole 13, during fibula bone-culting operation, operator can be guided at fibula
Offer screwed hole on 4, and by screw, the first osteotomy guide plate 11 is connected and fixed with fibula 4, make
First osteotomy guide plate 11 is held in a predetermined position, and more firm stable, it is to avoid slide during osteotomy operation
Move, reduce osteotomy operation and predetermined operation plan error, make fibula bone-culting operation be easier to make for, it is simple to art
Person operates；The osteotomy part of fibula 4 is performed the operation for follow-up reconstruction of jaw as bone graft 41, reconstruction of jaw
Time, the screwed hole on fibula 4 (namely bone graft 41) corresponding first guides installing hole 13 and also is provided with multiple,
Wherein, at least two screwed hole is corresponding with the connecting hole on titanium plate, and at least two screwed hole and the 3rd guides
Bone graft fixing hole on localizer 3 is corresponding.Thus, by the first setting guiding installing hole 13, same
Time be that titanium plate, bone graft 41 and the 3rd in the operation of follow-up reconstruction of jaw guides the connection between localizer 3 to carry
For unified screwed hole, it is to avoid titanium plate, bone graft 41 and the 3rd guide the localizer 3 to fix secondary drilling and make
The bone graft damage become, also ensure that titanium plate, bone graft 41 and the 3rd guide localizer 3 at jaw defect just
The accuracy of position.
More preferably, the two ends of described first osteotomy guide plate 11 are respectively arranged with the first section leads limit 16, and this is years old
One section leads limit 16 is the leader of fibula osteotomy boundary line, fibula osteotomy border in guided operation
The position of line and direction, under the first osteotomy guide plate 11 instructs, along fibula osteotomy boundary line, (the i.e. first cross section is led
To limit 16) cut down to precise and safety the plan osteotomy part of fibula 4.Further, described first section leads
Limit 16 is protruding from the end face of described first osteotomy guide plate 11, thus facilitates osteotomy operation to look at straight in sight
Under carry out, moulding more controllable to complicated osteotomy, it is ensured that osteotomy surface is more accurate.
More preferably, described first osteotomy guide plate 11 is provided with bending and guides fracture 17, and described bending guides fracture
17 is V-shaped.Jawbone is the L-type of complexity, arch mixture, and fibula 4 is as strip long bone, and needs are many
Secondary block, fracture moulding to mate jaw defect profile.And bend that guiding fracture 17 is bootable once completes calf
Bone blocks moulding, convenient to operation, and accurately mates the bending structure of jaw defect.It is additionally, since and examines
Considering to bending guiding fracture 17 is that the first osteotomy guide plate is disconnected two parts, operates for convenience, described first section
Bone conduction plate 11 is provided with handle 18, and the two ends of described handle 18 are connected to described bending and guide the both sides of fracture 17
Described first osteotomy guide plate 11 on, thus the two parts that be will be switched off by this handle 18 are connected.
The use process of the first guiding localizer 1 is as follows:
(1) location latch closure 12 is fastened on the position that the osteotomy part two ends with fibula 4 are connected, now,
Location latch closure 12 is fixed；
(2) after the tenon 14 being directed at by the tongue-and-groove 15 on the first osteotomy guide plate 11 on the latch closure 12 of location closes,
First osteotomy guide plate 11 is connected and fixed with location latch closure 12；
(3) the first guiding installing hole 13 utilizing screw to pass on the first osteotomy guide plate 11 is tightened in fibula 4
In corresponding screwed hole, the first osteotomy guide plate 11 is made to be connected and fixed with fibula 4；
(4) pulling down location latch closure 12, the bending along the first section leads limit 16 and V-shaped guides fracture
17 carry out the moulding operation of osteotomy.
As it is shown on figure 3, the form that specifically arranges of described second guiding localizer 2 is as follows:
Described second guides localizer 2 to include two pieces of sclerotin positions being arranged at Jaw neoplasm 51 both sides front and back
Second osteotomy guide plate 21, described second osteotomy guide plate 21 be provided with jawbone outside surface of bone laminating medial surface, institute
State the second osteotomy guide plate 21 to be provided with for guiding operator offer screwed hole on jawbone 5 and be available for described
The second guiding installing hole 22 that second osteotomy guide plate 21 is connected with jawbone 5.
In the present embodiment, obtain the head mathematical model of patient by CBCT or CT scan, by software three
Dimension reconstruction technique sets up Three-dimensional model.Computer software is used to formulate hands on 3-dimensional digital skull model
Art scheme also draws excision boundary line and screwed hole, according to scope and the position of screwed hole of excision boundary line
Draw the profile of two piece of second osteotomy guide plate 21, and use the non-toxic material such as resin, plastics to be printed by 3D
Forming technique is fabricated to the second osteotomy guide plate 21 of entity.The medial surface of the second osteotomy guide plate 21 is according to jawbone 5
Outside outside surface of bone form generating, with jawbone 5, surface of bone is affixed completely；Second guide installing hole 22 at least provided with
2, according to the second position guiding installing hole 22, during Jaw neoplasm resection operation, operator can be guided
Jawbone 5 is offered screwed hole, and by screw, the second osteotomy guide plate 21 is linked together with jawbone 5,
The second osteotomy guide plate 21 is made to be held in a predetermined position and firm stable, it is to avoid to slide during excision Jaw neoplasm
Move, reduce osteotomy operation and predetermined operation plan error, make Jaw neoplasm resection operation be easier to make for, just
Operate in patient.During reconstruction of jaw, screwed hole on jawbone 5 corresponding second guide installing hole 22 at least provided with
Two, wherein, at least one is corresponding with the connecting hole on titanium plate, and at least one guides localizer 3 with the 3rd
On jawbone fixing hole corresponding.Thus, by the second setting guiding installing hole 22, for follow-up jawbone weight
Build the titanium plate in operation and the 3rd to guide and connect the screwed hole providing unified between localizer 3, it is to avoid titanium
Plate and the 3rd guides localizer 3 to fix the jawbone damage that secondary drilling causes, and also ensures that titanium plate and the 3rd guiding
The accuracy that localizer 3 is in place at jaw defect.
More preferably, described second osteotomy guide plate 21 is provided with the second section leads limit near Jaw neoplasm 51 side
23, this second section leads limit 23 is the leader of excision boundary line, excises border in guided operation
The position of line and direction, guide lower along excision (the i.e. second section leads limit, boundary line through the second osteotomy guide plate 21
23) precise and safety ground excision Jawbone Pathoses region, it is to avoid residual, effectively reduces the risk of postoperative recurrence.Enter
One step, described second section leads limit 23 is protruding, thus from the end face of described second osteotomy guide plate 21
Convenient excision operation is carried out under sight is looked at straight, it is ensured that Jaw neoplasm precisely excises.
More preferably, the lateral surface of described second osteotomy guide plate 21 is provided with boss 24, and described second guides installation
Hole 22 is opened in described boss 24 central authorities.The height of this boss 24 is about 3mm, auger shell pit or on spiral shell
Guiding function is played, it is ensured that screwed hole or screw direction are consistent with anticipated orientation and be perpendicular to surface of bone during Si,
The second osteotomy guide plate 21 can be made after tightening the screw to be close to surface of bone.
More preferably, described second osteotomy guide plate 21 extends the buckling parts 25 that oriented jawbone 5 edge holds, with really
Protect the second osteotomy guide plate 21 the most in place, reduce operation technique error.As a example by Submandibular neoplasms excises, position
The second osteotomy guide plate at the sclerotin position on front side of Submandibular neoplasms extends the fastening that oriented chin subordinate's edge holds
Portion, is positioned at the second osteotomy guide plate at the sclerotin position on rear side of Submandibular neoplasms and is extended with and holds to lower border of the mandible
Buckling parts.
The use process of described second guiding localizer 2 is as follows:
(1) the second guiding installing hole 22 utilizing screw to pass on the second osteotomy guide plate 21 is tightened in jawbone 5
In corresponding screwed hole, the second osteotomy guide plate 21 is made to be connected and fixed with jawbone 5；
(2) Jaw neoplasm excision operation is carried out along the second section leads limit 23；
(3), after Jaw neoplasm excision, the second guiding localizer 2 is removed.
As shown in Figures 4 to 6, the form that specifically arranges of described 3rd guiding localizer 3 is as follows:
Described 3rd guides localizer 3 to include bone graft guided plate 31, Dental implantion bullport seat 32, anterior jaw
Bone fixation plate 33 and rear portion jawbone fixed plate 34, the guide tracks of described bone graft guided plate 31 and jawbone 5
The extension track rebuild coordinates consistent, and described bone graft guided plate 31 offers some bone graft fixing holes 35,
Described bone graft fixing hole 35 is corresponding with the screwed hole on fibula 4 (namely bone graft 41), described tooth kind
Plant bullport seat 32 to be arranged on described bone graft guided plate 31 and its aperture is relative with bone graft 41, described
Anterior jawbone fixed plate 33 and rear portion jawbone fixed plate 34 are connected to the two of described bone graft guided plate 31
Hold and be provided with and the medial surface of corresponding jawbone 5 surface of bone laminating, described anterior jawbone fixed plate 33 and rear portion jaw
Some jawbone fixing holes 36, described jawbone fixing hole 36 and the spiral shell on jawbone 5 it is equipped with in bone fixation plate 34
Pit is corresponding.
In the present embodiment, obtain the head mathematical model of patient by CBCT or CT scan, by software three
Dimension reconstruction technique sets up Three-dimensional model.Computer software is used to formulate hands on 3-dimensional digital skull model
Art scheme and draw bone graft guided plate 31, Dental implantion bullport seat 32, anterior jawbone fixed plate 33 and after
The profile of portion's jawbone fixed plate 34, and use the non-toxic material such as resin, plastics by 3D printing shaping technology
Make all-in-one-piece bone graft guided plate 31, Dental implantion bullport seat 32, anterior jawbone fixed plate 33 and after
Portion's jawbone fixed plate 34.Bone graft guided plate 31 extends track form generating, bone graft according to virtual bone graft
Bone graft fixing hole 35 on guided plate 31 is corresponding with the screwed hole on bone graft 41 (i.e. fibula 4),
Bone graft 41 is screwed on bone graft guided plate 31, thus utilizes drawing of bone graft guided plate 31
It is matched unanimously that guide rail mark makes bone graft 41 extend track, it is ensured that bone graft is accurately positioned and fixing.Described
Dental implantion bullport seat 32, according to the position of reconstruction of jaw, such as mandibular bone, is then arranged at described bone graft and guides
The upside of plate 31 and its aperture are relative with the top surface of bone of bone graft 41, such as upper jaw bone, are then arranged at described
The downside of bone graft guided plate 31 and its aperture are relative with the bottom surface of bone of bone graft 41, so that it is guaranteed that plantation
The optimum position of body implantable graft bone center of top.Described anterior jawbone fixed plate 33 and rear portion jawbone fixed plate
The medial surface of 34 is all according to the complete phase of surface of bone outside surface of bone form generating, with jawbone 5 outside corresponding jawbone 5
Patch；Described jawbone fixing hole 36 is corresponding with the screwed hole on jawbone 5, anterior jawbone fixed plate 33 and after
Portion's jawbone fixed plate 34 is screwed in before and after jaw defect position on the sclerotin of both sides respectively, thus really
Guarantor's bone graft guided plate 31 is the most in place and is fixed on desired location.Visible, the present invention use collection Dental implantion and
Mandible reconstruction is in integral structure, by designing Dental implantion bullport seat 32 on bone graft guided plate 31,
Can make bone graft guided plate 31 while guiding reconstruction of jaw operation, assist Dental implantion part operation, as
Implantation hole preparation, implantation body implant, and are greatly improved operation precision and success rate.
More preferably, described bone graft guided plate 31 extends on the upside of oriented bone graft 41 or downside holds first
Buckling parts 311, described Dental implantion bullport seat 32 is arranged on described first buckling parts 311；Described front portion
The side of jawbone fixed plate 33 extends the second buckling parts 331 that oriented jawbone 5 edge holds, described anterior jaw
The opposite side of bone fixation plate 33 is provided with the 3rd buckling parts 332 fastened with tooth or teeth space；Described rear portion jawbone
Fixed plate 34 extends the 4th buckling parts 341 that oriented jawbone 5 edge holds.As a example by mandible reconstruction, move
The upside of bone grafting guided plate 31 extends the first buckling parts 311 held on the upside of oriented bone graft 41, and Dental implantion draws
Guide hole seat 32 is arranged on the first buckling parts 311, and this first buckling parts 311 can be by Dental implantion bullport seat 32
Causing on the upside of bone graft 41, the aperture making Dental implantion bullport seat 32 is relative with the top surface of bone of bone graft 41；
The downside of anterior jawbone fixed plate 33 extends the second buckling parts 331 that oriented chin subordinate's edge holds, anterior jawbone
The upside of fixed plate 33 is provided with the 3rd buckling parts 332 fastened with tooth and teeth space, so that anterior jawbone is solid
Determine plate 33 to fit completely patient's chin portion's sclerotin and dental area, make bone graft guided plate 31 and front portion be good under side
Jawbone accurate match；The downside of rear portion jawbone fixed plate 34 is extended with the 4th buckling parts held to angle of mandible
341, patient's angle of mandible position sclerotin so that rear portion jawbone fixed plate 34 is fitted completely, make bone graft guide
Side Mandibular Rumas accurate match is good at plate 31 and rear portion.Thereby, it is possible to guarantee that bone graft guided plate 31 is accurate
In place, reduce operation technique error.
More preferably, the central axis in the hole of described Dental implantion bullport seat 32 in bone graft 41 surface of bone, from
And make the gmatjpdumamics of implantation body along implantation body's major axis transmission, provide good fixing foundation for kind of tooth.
More preferably, described Dental implantion bullport seat 32 coordinates it is plugged with leading of being available for that different-diameter drill bit passes
Post 37, described guide pillar 37 includes that cylinder-shaped body 371, described cylinder-shaped body 371 are provided with and described tooth kind
Planting the shoulder hole 372 that the hole of bullport seat 32 communicates, the top of described shoulder hole 372 is that major diameter coupling expands
Hole drill brake, plays direction guiding function to reamer, when drill bit reaches predetermined during drill bit gos deep into
During the degree of depth, baseplane, shoulder hole 372 top and drill bit Stopper contact, make drill bit stop deeply, to guarantee
The degree of depth of plantation nest is consistent；The bottom of shoulder hole 372 is that minor diameter mates reamer drill bit, at drill bit deeply
During guiding function is played in standby direction, hole.Operation process needs to change step by step the guide pillar 37 of different pore size,
Corresponding reamer can be changed to mate guide pillar 37 simultaneously, thus effectively prevent that bore diameter is excessive causes shifting
Bone grafting major injury.
More preferably, the periphery of described cylinder-shaped body 371 is provided with lobe 373, described lobe 373 times
Surface coordinates with the upper surface of described Dental implantion bullport seat 32, in operation process, needs to plug in guide pillar 37
Enter in the hole of Dental implantion bullport seat 32, when lobe 373 is in close contact the upper of Dental implantion bullport seat 32
During surface, i.e. show that guide pillar 37 is in place and complete.
The use process of described 3rd guiding localizer 3 is as follows:
(1) the bone graft fixing hole 35 utilizing screw to pass on bone graft guided plate 31 is tightened in bone graft 41
In the screwed hole that (i.e. fibula 4) is corresponding, bone graft 41 is made to be fixed on bone graft guided plate 31, to transplanting
Bone 41 carries out moulding location；
(2) jawbone utilizing screw to pass in anterior jawbone fixed plate 33 and rear portion jawbone fixed plate 34 is fixed
Hole 36 is tightened in the screwed hole of jawbone 5 correspondence, makes to be fixed with the bone graft guided plate 31 of bone graft 41 even
Receive at jaw defect, make the two ends end face of bone graft 41 engage with being front and back good for side jawbone 5 osteotomy surface；
(3) utilize screw to pass the connecting hole on titanium framework (i.e. titanium plate) and be tightened in the screw thread of jawbone 5 correspondence
In hole, make titanium framework be fixed at jaw defect, utilize screw to pass the connecting hole on titanium framework (titanium plate)
It is tightened in the screwed hole that bone graft 41 (i.e. fibula 4) is corresponding, makes titanium plate and bone graft 41 be fixed together；
(4) unclamp the screw on bone graft fixing hole 35 and jawbone fixing hole 36, remove the 3rd guiding location
Device 3, completes the fixing operation of bone graft.
Also, it should be noted during mandible reconstruction, described bone graft guided plate 31 can also arrange an edge
The titanium plate locating slot that bone graft 41 track extends, makes interior fixing titanium framework (i.e. titanium plate) be located in desired location,
And bone graft 41 surface of bone of fitting completely, it is ensured that bone collection is accurately implemented.Further, on described titanium plate locating slot
Offer and some be available for whole screw through the through hole that linked together with bone graft 41 by titanium plate.Removing the
During three guiding localizers 3, retain the screw on this lead to the hole site, to keep the company between titanium plate and bone graft
Connect, and unclamp the most removable 3rd guiding of screw on bone graft fixing hole 35 and mandibular bone fixing hole 36 position
Localizer 3.
Above disclosed only presently preferred embodiments of the present invention, can not limit the present invention with this certainly
Interest field, the equivalent variations therefore made according to scope of the present invention patent, still belong to the present invention and contained
Scope.
Claims (10)
1. increase the guiding positioning component excising for Jaw neoplasm and rebuilding that material manufactures, it is characterised in that root
According to Jaw neoplasm excision and reconstruction operations process include successively the first guiding localizer, second guide localizer with
And the 3rd guide localizer, described first guides localizer to be fixed on fibula, and assists fibula osteotomy moulding；
Described second guides localizer to be fixed on the sclerotin position of both sides before and after Jaw neoplasm, and assists Jaw neoplasm to cut
Remove；Described 3rd guides localizer to be connected with the osteotomy part of fibula, and the described 3rd guides localizer to be connected to
Before and after after excision Jaw neoplasm between the sclerotin position of both sides, and using the osteotomy part of fibula as bone graft
Auxiliary reconstruction of jaw；Described first guides localizer, the second guiding localizer and the 3rd to guide localizer all to adopt
3D printing shaping is passed through with resin or plastics.
2. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 1
Part, it is characterised in that described first guides localizer to include the first osteotomy guide plate and location latch closure, described the
One osteotomy guide plate is provided with the long trough curve-surface cavity of the osteotomy part surface of bone laminating with fibula, described location latch closure
It is provided with two, is buckled in position that the osteotomy part two ends with fibula are connected respectively and leads with described first osteotomy
The two ends of plate connect, and described location latch closure is provided with the ring of the position fastening that the osteotomy part two ends with fibula are connected
The long trough curved surface of shape curve-surface cavity, the annular surface die cavity of described location latch closure and described first osteotomy guide plate
Die cavity abrupt transition, described first osteotomy guide plate is provided with multiple for guiding operator to offer spiral shell on fibula
Pit and be available for the first guiding installing hole that the first osteotomy guide plate is connected with fibula.
3. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 2
Part, it is characterised in that the end of described location latch closure is extended with tenon, the two ends of described first osteotomy guide plate
It is respectively equipped with the tongue-and-groove being connected with described tenon.
4. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 2
Part, it is characterised in that described first osteotomy guide plate be respectively arranged at two ends with the end from described first osteotomy guide plate
Face out the first section leads limit stretched out；Described first osteotomy guide plate is provided with bending and guides fracture, described
It is V-shaped that bending guides fracture.
5. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 2
Part, it is characterised in that described second guides localizer to include, and two pieces are arranged at the bone of both sides before and after Jaw neoplasm
The second osteotomy guide plate at matter position, described second osteotomy guide plate be provided with jawbone outside surface of bone laminating medial surface,
Described second osteotomy guide plate is provided with for guiding operator offer screwed hole on jawbone and be available for described
The second guiding installing hole that two osteotomy guide plates are connected with jawbone.
6. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 5
Part, it is characterised in that the described second osteotomy guide plate end face near Jaw neoplasm side be provided with from this end face to
The the second section leads limit overhang；The lateral surface of described second osteotomy guide plate is provided with boss, described guiding
Installing hole is opened in described boss central authorities；Described second osteotomy guide plate extends the fastening that oriented jawbone edge holds
Portion.
7. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 5
Part, it is characterised in that described 3rd guide localizer include bone graft guided plate, Dental implantion bullport seat,
Anterior jawbone fixed plate and rear portion jawbone fixed plate, the guide tracks of described bone graft guided plate and reconstruction of jaw
Extension track coordinate consistent, described bone graft guided plate offers some bone graft fixing holes, described shifting
Bone grafting fixing hole is corresponding with the screwed hole on fibula, and described Dental implantion bullport seat is arranged at described bone graft
On guided plate and its aperture is relative with bone graft, and described anterior jawbone fixed plate and rear portion jawbone fixed plate are respectively
It is connected to the two ends of described bone graft guided plate and is provided with and the medial surface of corresponding jawbone surface of bone laminating, described
It is equipped with some jawbone fixing holes, described jawbone fixing hole in anterior jawbone fixed plate and rear portion jawbone fixed plate
Corresponding with the screwed hole on jawbone.
8. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 7
Part, it is characterised in that the first button that described bone graft guided plate extends on the upside of oriented bone graft or downside holds
Conjunction portion, described Dental implantion bullport seat is arranged on described first buckling parts；Described anterior jawbone fixed plate
Side extends the second buckling parts that oriented jawbone edge holds, and the opposite side of described anterior jawbone fixed plate is provided with
The 3rd buckling parts fastened with tooth or teeth space；Described rear portion jawbone fixed plate extends oriented jawbone edge and holds
The 4th buckling parts.
9. the guiding location group excised for Jaw neoplasm and rebuild increasing material manufacture as claimed in claim 7
Part, it is characterised in that the central axis in the hole of described Dental implantion bullport seat is in bone graft surface of bone, described
Coordinating to be plugged with on Dental implantion bullport seat and be available for the guide pillar that different-diameter drill bit passes, described guide pillar includes circle
Cylindrical bodies, described cylinder-shaped body is provided with the shoulder hole that the hole with described Dental implantion bullport seat communicates, institute
The top stating shoulder hole is major diameter, and bottom is minor diameter；The periphery of described cylinder-shaped body is provided with lobe,
The lower surface of described lobe coordinates with the upper surface of described Dental implantion bullport seat.
10. the guiding location for Jaw neoplasm excision and reconstruction increasing material manufacture as claimed in claim 7
Assembly, it is characterised in that described bone graft guided plate is provided with the titanium plate locating slot extended along bone graft track,
Offer on described titanium plate locating slot and some to be available for whole screw through titanium plate and bone graft being linked together
Through hole.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610288256.6A CN105852931B (en) | 2016-05-03 | 2016-05-03 | The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610288256.6A CN105852931B (en) | 2016-05-03 | 2016-05-03 | The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN105852931A true CN105852931A (en) | 2016-08-17 |
| CN105852931B CN105852931B (en) | 2018-09-07 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201610288256.6A Active CN105852931B (en) | 2016-05-03 | 2016-05-03 | The guiding positioning component for cutting off and rebuilding for Jaw neoplasm of increasing material manufacturing |
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| CN106109021A (en) * | 2016-08-31 | 2016-11-16 | 复旦大学附属华山医院 | Scalable arc frons pattern guide plate |
| CN107320155A (en) * | 2017-06-30 | 2017-11-07 | 深圳市倍康美医疗电子商务有限公司 | A kind of digitlization forming method of intraoral tumor resection and repairing accessory |
| CN108606823A (en) * | 2016-12-09 | 2018-10-02 | 深圳市普天阳医疗科技股份有限公司 | A kind of mandibular resetting apparatus and production method |
| CN109662770A (en) * | 2019-01-15 | 2019-04-23 | 上海交通大学医学院附属第九人民医院 | A kind of titanium alloy Sandwich bone grafting maintenance titanium plate that three-dimensional printing technology generates |
| CN110313994A (en) * | 2019-03-18 | 2019-10-11 | 江苏时间环三维科技有限公司 | A kind of directing plate in place applied to the two-fold mandible reconstruction of multistage fibula |
| CN111481281A (en) * | 2020-04-21 | 2020-08-04 | 上海交通大学医学院附属第九人民医院 | Method for reconstructing mandible by internally fixed fibula |
| US20200352679A1 (en) * | 2019-05-09 | 2020-11-12 | DDS Company, Inc. | Tissue Borne Fixation System, Device, and Methods of Making and Using Same |
| CN112076002A (en) * | 2020-10-13 | 2020-12-15 | 四川大学 | GBR middle periosteum nail position and direction positioning guide plate and manufacturing method thereof |
| CN113017765A (en) * | 2021-02-22 | 2021-06-25 | 上海交通大学医学院附属第九人民医院 | Integrated mandible osteotomy external fixation device and use method |
| CN114569260A (en) * | 2020-11-18 | 2022-06-03 | 中山大学附属口腔医院 | Guiding plate for positioning after maxillary osteotomy |
| IT202100002270A1 (en) | 2021-02-03 | 2022-08-03 | Univ Degli Studi Di Torino | MANDIBLE CUT GUIDE |
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| CN106109021A (en) * | 2016-08-31 | 2016-11-16 | 复旦大学附属华山医院 | Scalable arc frons pattern guide plate |
| CN106109021B (en) * | 2016-08-31 | 2022-06-24 | 复旦大学附属华山医院 | Adjustable arc forehead portion mode baffle |
| CN108606823A (en) * | 2016-12-09 | 2018-10-02 | 深圳市普天阳医疗科技股份有限公司 | A kind of mandibular resetting apparatus and production method |
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| CN109662770B (en) * | 2019-01-15 | 2024-03-22 | 上海交通大学医学院附属第九人民医院 | Titanium alloy Sandwich bone grafting and fixing titanium plate generated by three-dimensional printing technology |
| CN109662770A (en) * | 2019-01-15 | 2019-04-23 | 上海交通大学医学院附属第九人民医院 | A kind of titanium alloy Sandwich bone grafting maintenance titanium plate that three-dimensional printing technology generates |
| CN110313994A (en) * | 2019-03-18 | 2019-10-11 | 江苏时间环三维科技有限公司 | A kind of directing plate in place applied to the two-fold mandible reconstruction of multistage fibula |
| CN110313994B (en) * | 2019-03-18 | 2022-07-05 | 江苏时间环三维科技有限公司 | Be applied to two guide boards of taking one's place that rebuild mandible of folding of multistage fibula |
| US20200352679A1 (en) * | 2019-05-09 | 2020-11-12 | DDS Company, Inc. | Tissue Borne Fixation System, Device, and Methods of Making and Using Same |
| US11819382B2 (en) * | 2019-05-09 | 2023-11-21 | DDS Company, Inc. | Tissue borne fixation system, device, and methods of making and using same |
| CN111481281A (en) * | 2020-04-21 | 2020-08-04 | 上海交通大学医学院附属第九人民医院 | Method for reconstructing mandible by internally fixed fibula |
| CN111481281B (en) * | 2020-04-21 | 2022-12-27 | 上海交通大学医学院附属第九人民医院 | Preparation method of internal fixing device for fibula reconstruction mandible |
| CN112076002A (en) * | 2020-10-13 | 2020-12-15 | 四川大学 | GBR middle periosteum nail position and direction positioning guide plate and manufacturing method thereof |
| CN114569260A (en) * | 2020-11-18 | 2022-06-03 | 中山大学附属口腔医院 | Guiding plate for positioning after maxillary osteotomy |
| IT202100002270A1 (en) | 2021-02-03 | 2022-08-03 | Univ Degli Studi Di Torino | MANDIBLE CUT GUIDE |
| CN113017765A (en) * | 2021-02-22 | 2021-06-25 | 上海交通大学医学院附属第九人民医院 | Integrated mandible osteotomy external fixation device and use method |
| USD1006225S1 (en) | 2022-03-17 | 2023-11-28 | DDS Company, Inc. | Foundation guide seating site |
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